The continuing ignoring of mental health issues of Syrian refugees could harm us all

After, eight years into the brutal Syrian crisis, the exact scale and impact of psychological trauma, mental health challenges and Post-Traumatic Stress Disorder on both children and adults are not well-known, nor are they prioritized by local and international aid agencies, relief organizations and governments. But we know the psychological toll of the conflict is significant.

Background:

With close to 4 million refugees, Turkey continues to be home to the world’s largest refugee population. Almost 50 % of all refugees in Turkey are registered in four key provinces: Gaziantep, Hatay, Istanbul and Sanliurfa. Refugees in their youth are approximately one million in Turkey, and are aged between 15 and 24, of which 60 % are male. Most of the refugees in Turkey live in urban centers, due to the highest chance they have to make a living. According to the last updated census, there are 3,622,366 Syrian refugees in Turkey, 44.9% are under 18, and 13% (6% females, 7% males) are adolescents of age 12 to 17.

Mental Health and Psychosocial Context

Before fleeing Syria and during the journey to Turkey, many Syrians have witnessed or experienced the death of loved ones, physical harm, violent and terrifying situations. The psychological impact of conflict-related violence coupled with the ongoing stressors related to displacement can have a significant impact on the mental health and psychosocial well-being of Syrian refugee adults and children. Some of these ongoing challenges include lack of resources, risks of exploitation, violence, discrimination, disruption of social networks, and lack of livelihood options. These challenges can result in a sense of hopelessness, which in turn contribute to psychological distress, increased family violence, diminished sense of dignity and control, and a reliance on negative coping skills (Hassan, Kirmayer, & Mekki-Berrada, 2015). Pre-existing mental health conditions may be exacerbated, or psychosocial distress may be brought on by daily stressors (Hassan et al., 2015). As the conflict shifts into a protracted crisis, it is important to gain and understanding of Syrian culture-specific expressions of distress, healing practices, and coping strategies. Understanding the way in which Syrians may experience and cope with psychological distress and mental health problems can offer practitioners insight into how to be the most helpful. This can be used to develop programming that is most effective for the Syrian refugee population, shaping community initiatives to promote resilience and increase the use of positive coping mechanisms.

In 2018, UNHCR considered prioritizing the response for children identified at higher risk, as a part of its priority activities, UNHCR concentrates on this priority through a child protection systems-building approach. UNHCR’s capacity development for staff and partners emphasizes best interest procedures as part of the individual Case Management System.

Overall Objective:

Enhance mental health status of the Syrian refugees living in Turkey.

Beneficiaries: Thousands of Syrian refugees (children and adults).

Location: Hatay, Turkey.

The project Intervention:

Kids Paradise will establish a mental health center provides comprehensive mental health services, including psychosocial support and cases management, and through two approaches, fixed and outreach.

Outreach Team

Mental Health Center

In addition, this project aims to provide technical training to MH workers and teachers. The project intervention can be explained through the following three components:

1- Awareness raising:

This project aims at sensitizing the community about the concept of mental health, in general, and about the mental health best practices, in specific. The project will target the local community, host and refugees.

2- Mental Health technical capacity building:

This project has a technical capacity-building component with two approaches:

3- Provision of quality mental health service:

This intervention also is going to be implemented through two approaches:

The first approach is providing specialized mental health service to Syrian refugees in need of mental health service in the center; this service will include Psychological First Aid PFA, Psychosocial Support PSS, and Case Management. Moreover, the cases management service will be by detecting the cases (By the outreach team), providing the needed PSS through individual sessions, and referring the cases in need of medical intervention (medication) to the specialized governmental hospital, in addition, of course, to following up with the cases to keep providing logistic or financial support. The estimated percentage is 4 – 6% of the beneficiaries will be in need of the referral system.

The second approach is to provide group and individual PSS sessions to Syrian refugees in need of mental health through the outreach team. The detailed service is as explained in the first approach, and the specialized psychiatrist will supervise the case management. The outreach team will conduct regular visits to schools and cultural centers, and will conduct home visits to serve the elderly and people affected by disability.